Bmc Health Serv Res
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Bmc Health Serv Res · Feb 2019
Better cardiac care: health professional's perspectives of the barriers and enablers of health communication and education with patients of Aboriginal and Torres Strait Islander descent.
A body of knowledge continues to grow regarding Aboriginal perspectives on current challenges and barriers to health literacy and access to health services. However, less is known from the perspectives of health professionals who work in cardiac care. Given their role in delivering patient education, health practitioners could provide useful insights into potential solutions to improve patient-practitioner communication. The primary aim was to explore perspectives of health professionals who work in coronary care units regarding the enablers, barriers and potential solutions for patient-practitioner communication with patients of Aboriginal and Torres Strait Islanders descent. The secondary aim was to evaluate the acceptability and value of two videos developed with key stakeholders to provide culturally appropriate education. ⋯ Re-modelling of organisational structures is required in order to promote a more culturally-friendly and welcoming environment to encourage Aboriginal and Torres Strait Islanders to engage with mainstream cardiac care services. The videos that were developed using principles that are sensitive to Aboriginal health views, may offer an additional way in which to overcome existing barriers to effective patient-practitioner communication with Aboriginal and Torres Strait Islanders.
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Bmc Health Serv Res · Feb 2019
China's new policy for healthcare cost-control based on global budget: a survey of 110 clinicians in hospitals.
The increasing cost on healthcare exposes China's healthcare budgets and system to financial crisis. To control the excessive growth of healthcare expenditure, China's healthcare reforms emphasize the control of the global budget for healthcare, which leads to the release of relevant policy and a series of cost-control actions implemented by different hospitals. This work aims to identify the effects brought by the cost-control policy and actions via surveying and analysing feedback from clinicians. ⋯ Cost-control actions implemented in hospitals in response to the government's policy to reduce its national healthcare budget affect both doctors and patients in several ways. Moreover, the cost-control policy and actions can be improved.
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Bmc Health Serv Res · Jan 2019
Multicenter StudyPerceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective.
The Four-Hour Rule or National Emergency Access Target policy (4HR/NEAT) was implemented by Australian State and Federal Governments between 2009 and 2014 to address increased demand, overcrowding and access block (boarding) in Emergency Departments (EDs). This qualitative study aimed to assess the impact of 4HR/NEAT on ED staff attitudes and perceptions. This article is part of a series of manuscripts reporting the results of this project. ⋯ Findings provide information on the social interactions associated with the introduction of the 4HR/NEAT policy and the intended and unintended consequences of its implementation across Australia. These themes allowed us to develop several hypotheses about the driving forces behind the social impact of this policy on ED staff and will allow for development of interventions that are rooted in the rich context of the staff's experiences.
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Bmc Health Serv Res · Jan 2019
Frailty and health services use among Quebec seniors with non-hip fractures: a population-based study using adminsitrative databases.
The number of frail elderly will increase as the world population ageing accelerates. Since frail elders are at risk of falls, hospitalizations and disabilities, they will require more health care and services. To assess frailty prevalence using health administrative databases, to examine the association between frailty and the use of medical services and to measure the excess use of health services following a non-hip fracture across frailty levels among community-dwelling seniors. ⋯ Our results suggest that it is possible to characterize seniors' frailty status at a population level using health administrative databases. Furthermore, this study shows that non-institutionalized frail seniors require more health services after an incident fracture. Screening for frailty in seniors should be part of clinical management in order to identify those at a higher risk of needing health services.
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Bmc Health Serv Res · Jan 2019
Organizational issues for the lean success in China: exploring a change strategy for lean success.
The purpose of this paper is to explore a change strategy for lean success in hospitals based on a comprehensive review of the Chinese literature. ⋯ This is the first paper to provide a comprehensive view of lean application in Chinese hospitals. The findings presented in this paper provide a systemic evidence to the application of lean in healthcare.